Resonant muscle stimulator

ABSTRACT

A method and apparatus include a therapeutic or developmental apparel that includes hardware and/or software for stimulating a muscle. Such apparel may comprise, for instance, of: a glove, a uniform, a shoe, a sock, a vest, a sleeve, a shirt, a hat, a helmet, a brace, a suspender, eye wear, a pad, jewelry, a watch and pants. A muscle of a user may be stimulated by the garment as the user moves, such as a when a golfer practices her swing. Combining such muscle stimulation with the act of practicing the movement of the swing has a synergistic effect of training the muscle as it builds strength. Similarly, a partial paralytic may regain strength in their hand by wearing a vest or other garment configured to transcutaneously deliver a stimulating signal. Where desired, the garment may include at least one electrode configured to deliver a stimulating signal to the wearer. In another or the same embodiment, wired electrodes may extend from the garment or an adjacent signal generator to the wearer. This configuration may allow other, targeted muscles to be concurrently stimulated while the user wears the garment.

CROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application is a continuation of U.S. patent applicationSer. No. 10/047,745 entitled “Resonant Muscle Stimulator” filed on Jan.15, 2002, and claims the benefit of the filing date thereof. Thisapplication is also related to the continuation-in-part application,U.S. patent application Ser. No. 10/789,861 entitled “Resonant MuscleStimulator” filed on Feb. 27, 2004. The entire disclosure of those U.S.patent applications are incorporated into this application by reference.

FIELD OF THE INVENTION

[0002] The present invention relates generally to the field ofelectronic muscle stimulation, and more particularly to transcutaneousmuscle development.

BACKGROUND OF THE INVENTION

[0003] The ability to stimulate or exercise muscle tissue is critical tothe development and rehabilitation of muscle. In nature, alterations inion channels cause the brain to generate electronic impulses orsynapses. An impulse propagates along an axon to its termination on itsway to initiating a muscle contraction. As such, characteristics of theimpulse complement the active processes of the nervous system.Mechanically generated attempts to stimulate muscles often strive toemulate natural impulses, working within the confines of axon receptors.Therapists and athletes use machines that produce variations of suchsignals to develop muscle tissue by inducing a series of contractiletwitches that aggregate to form a contraction. Benefits of suchstimulation include the promotion of blood flow and the localizeddevelopment of muscle tissue.

[0004] Conventionally, such signals embody a series of discontinuouspulses. Despite charges being measurable in millivolts, each pulsecommunicates at least a minimum threshold potential to a muscle. Athreshold potential corresponds to a voltage level, or charge, asmeasured at a motor nerve, where the membrane of an axon experiencesdepolarization. Also called a firing level, it coincides with the momentof a twitch, where the potential in the axon releases its energy into acalcium/adenosine triphosphate (ATP) union at one or more togglingbridges in the sarcomere until the axon arrives at zero potential.

[0005] In this manner, the threshold potential presented via each pulseinitiates a full-fledged twitching reaction. That is, sarcomere tissueof a muscle creates one twitch worth of contractile force in response toan application of a generated threshold potential. Successive bridgingof adjacent sarcomere tissue comprises a contraction. Of note, atoggling reaction will not occur if the stimulus is sub-threshold inmagnitude, i.e., it fails to convey the requisite threshold potential.The contractile reaction at each bridge in the sarcomere is thereforeall-or-none. In this manner, conventional techniques repeat pulses ofidentical potential and duration to produce consecutive twitches thatadd up to a contraction. In this manner, each pulse of a signal willtheoretically stimulate a next twitch.

[0006] In nature, sarcomere bridges toggle simultaneously across thelength of each muscle as individual twitches aggregate to form a singlecontraction. In this manner, the twitches are said to toggle uniformlyacross a muscle. Such uniformity evades electrical attempts to stimulatemuscle. In contrast, conventional applications use single short pulsesthat may succeed in toggling a high concentration of sarcomere bridgesnear the electrodes, but ultimately fail to stimulate more distantbridges. That is, while a high frequency application may initiallytoggle more bridges, the shorter spacing of the pulses is too small toallow time for depolarization and nutritional replenishment, ultimatelyfrustrating continuing contraction.

[0007] As such, any contractile reaction initiated by the pulse is endedwithin a fraction of a second. Conversely, if the pulse rate is madeslow enough to allow for depolarization and nutritional replenishment,accommodation drops in proportion to the drop in frequency, thus thedeeper penetration is made possible. However, penetration comes at theexpense of pain from the yanking and dropping effect produced by thetoggling, de-toggling, re-toggling of more and more bridges in moresarcomeres with the increase in time between pulses as the frequencydrops.

[0008] Other prior art techniques attempt to affect larger portions ofthe muscle by extending pulse length. However, such attempts still failto achieve a uniform contraction. Namely, sarcomere bridges of theportion of the muscle nearest to the electrodes will release due topolarization and nutritional problems prior to an adjacent portion ofthe muscle toggling. The duration of the pulse causes the bridges insarcomeres closer to the center of the muscle to toggle, but only at thecost of painfully yanking the spent and relaxing sarcomeres nearest theelectrodes into a stretched condition as the process travels in a waveor ripple effect outward from the electrodes, but inward toward eachother.

[0009] By the time the bridges in the middle sarcomeres begin to toggle,the mass of the muscle has developed a crushing velocity to add to thetwitch. Those sarcomeres of the muscle nearest the electrodes havealready been spent. Despite the relatively weaker twitch of the centersarcomeres, the hyper-compression, as the sum of the above, nonetheless,tugs on adjacent sarcomeres. Over time, repeated applications willincreasingly stress and deplete energy supplies of muscle tissues.Repeated applications further produce relatively little beneficialeffect, because the muscles are being stretched out of shape,traumatized almost as much as they are being treated. Additionally, highcurrents associated with long pulses stings the skin of the user. Thus,stimulation of sarcomeres distally positioned from the electrodes hasnot been possible without incurring preclusive pain and potentialdamage.

[0010] Known techniques used to address such factors includeincorporating periods of recovery in between pulses. Sufficient lengthsof such periods may allow the muscle to partially prepare for anothercontractile twitch. Muscle may use this short period between pulses toreplenish a portion of expended ATP and calcium ions before thecontraction process continues, re-initiated by a subsequent pulse. Eachrest time between pulses also allows the body an opportunity topartially reset electrical polarities skewed by its preceding pulse bydissipating capacitance retained in the skin.

[0011] Despite these provisions, known pulse applications still sufferdiminished returns with successive pulses due to nutritional depletionand motor-nerve boredom. Unless the pulse rate is so slow that it causesa painful, jerking sensation, there is inadequate time between pulses toallow for complete replenishment and electrical recovery. Consequently,pulses of repeated strength and duration incrementally drain overallmuscle resources. As the muscles strength and supply wane, so does themuscle's ability to contract. As such, a subsequent pulse, identical inpolarity, amplitude, shape and timing produces shallow contractions thatresult in less penetration than the preceding pulse. Less penetrationtranslates into less muscle development, as weaker contractions fail toincrease blood flow to required muscle tissue levels as needed formuscle development.

[0012] Still other obstacles hinder the effectiveness of conventionalpulse signal applications. Namely, accommodation may prevent repeatedpulses from penetrating deeply into the muscle, mitigating the potentialbenefit of successive pulses. Muscle accommodation regards the abilityof the body to adapt to constant and repeated stimuli. Such stimuliincludes the successive pulses of conventional muscle stimulators. Assuch, a muscle adapts to subsequent pulses in such a manner as it failsto achieve the same level of potential in response to a repeated pulse.Two major factors contributing to accommodation relate to electricalpolarity and nutritional supply as discussed herein.

[0013] To compensate for the detrimental effects of accommodation, someapplications attempt to increase the voltage of subsequent pulses tomaintain comparable levels of stimulation. Other applications attempt tocombat accommodation by varying pulse shape, width, height andfrequency. Although such techniques can realize somewhat greatercontractile reactions with less voltage, a targeted muscle stilltwitches in response to each pulse to a lesser degree than to theprevious pulse. Further, while marginally effective in temporarilyachieving deeper penetration, such attempts still result in preclusivepain that frustrates further treatment. In part, this pain stems frominability of known application and pulse variations to affect motornerves (associated with muscle development) to the same degree assensory nerves (associated with pain). In this manner, conventionalpulse designers are limited in the range of voltage they can apply andthe depth of contractile reactions they can achieve.

[0014] Significantly, conventional techniques further fail to uniformlyaddress different types of muscle implicated in a treatment/developmentsession. An inability of prior art pulse applications to simultaneouslyand consistently stimulate both slow and fast twitch muscle types oftenresults in disproportionate muscle development. Such undesirabledevelopment detrimentally impacts balance, mobility and other motorconsiderations. The absence of uniformity is, in part, a product of howa single pulse induces different reactions in dissimilar muscle types ofa user. For instance, as a signal propagates through a patient orathlete, fast and slow twitch muscles respond differently toconventional pulses. This limitation is a product of the differentsensitivities and reaction rates of slow and fast twitch muscles.

[0015] Fast twitch muscle is developed in response to frequent, quickuse. Fast twitch muscle is common in muscle groups that control finemotor functions, such as the wrist and hand. Consequently, fast twitchmuscles process electrical stimuli relatively quickly. Of note, suchmuscles are prone to tire quickly and are vulnerable to overstimulation,causing tetany, a painful tightening of muscles. In contrast, slowtwitch muscles react more slowly to stimuli than do fast twitch muscles,and they tire less easily. Slow twitch muscles are developed wheresmooth, methodical muscle contractions are common. For instance, regularmotions and support realized by muscles of the back will typicallydevelop associated muscles as slow twitch.

[0016] The disparate reactive characteristics of slow and fast twitchmuscles preclude known transcutaneous signals from uniformly addressingboth muscle types. Namely, no conventional pulse train cansimultaneously sustain even distribution of contractile twitchingreactions throughout both fast and slow twitch muscles. Moreparticularly, a conventional train of pulses having a frequencysynchronized with the response time of a fast twitch muscle is too quickfor a slow twitch muscle to react to its fullest extent for the voltageapplied.

[0017] Such an application, to a great degree, fails to stimulate slowtwitch muscles and almost exclusively activates fast twitch musclesbecause the signal fails to propagate profound contractile twitcheswithin the sarcomere of the slow twitch muscle. That is, the signalneglects the slow twitch muscle in favor of the fast twitch when bothare inline with a signal, resulting in disproportionate development. Ofnote, high frequency pulses may still cause overstimulation in the fasttwitch muscle. Such over-stimulation causes fast twitch muscles topainfully tighten, ending a therapeutic session before any gain can berealized in the slow twitch muscle.

[0018] Conversely, slowing the frequency of pulses so as to target slowtwitch muscles can produce dissatisfactory results in fast twitchmuscles. Thus, any gains realized in the slow twitch muscle group may betempered by ineffectual and painful reactions in proximate fast twitchmuscles. For instance, slow pulse rates may promote a painful, jerkingreaction in fast twitch muscles. As a result, the rate of consecutivepulses may be too infrequent or painfully preclusive to substantiallyexercise or tax fast twitch muscles relative to the slow twitch muscle.In this manner, fast twitch muscles can act as a barrier to treatment ofslow twitch muscles in that the high sensitivity and low pain thresholdof the fast twitch muscles precludes more extensive propagation oftwitches throughout slower twitch muscles. As such, exercising slowtwitch muscles remains a challenge to conventional stimulators.

[0019] Consequently, what is needed is a single signal capable ofuniformly exercising muscle tissue, while accounting for nutritional,comfort and accommodation considerations.

SUMMARY OF THE INVENTION

[0020] The invention addresses these and other problems associated withthe prior art by providing in one aspect an apparatus, method, andprogram product configured to stimulate a musculature. Moreparticularly, embodiments consistent with the invention may apply aresonant sequence of pulses across the musculature. The resonantsequences may progress inwardly toward the center of the musculature viatwo electrodes positioned near its ends to uniformly initiate acontraction within the musculature.

[0021] Each resonant sequence may include at least three pulses. Thepulses are spaced relative to one another such that each pulsesubsequent to a previous pulse in the sequence is effective toprogressively stimulate and create tension in the muscle inwardly fromthe electrodes and toward the center of the musculature while holdingthe previously toggled bridges in position. Significantly, tensioncreated in at least a portion of the musculature by each preceding pulsein the resonant sequence is maintained.

[0022] Optimized frequencies of the resonant sequences enable the muscleto distinctly register a succession of pulse characteristics within thespan of a single contraction. More particularly, the width, spacing,polarity, amplitude and/or shape of pulses comprising a sequence may bevaried to combat accommodation and minimize discomfort. Such variationmay circumvent the natural tendency of the musculature to adjust to andotherwise accommodate the signal, ultimately translating into deepermuscle penetration and decreased discomfort. Provisions such asshortening the length of successive pulses and the use of faradicwaveform characteristics can further enable deeper penetration withrelatively smaller quantities and durations of applied voltage.

[0023] One embodiment that is consistent with the invention may includea therapeutic or developmental instrument that includes hardware and/orsoftware for stimulating a muscle. Such an instrument may comprise, forinstance, a golf club, a baseball bat, a lacrosse stick, a tennisracquet or a hockey stick, among other sports-related instruments. Stillother suitable instruments may include a writing instrument, such as apen. In the case of a golf club, a muscle of a user may be stimulated bythe instrument as the golfer practices her swing. Combining such musclestimulation with the act of practicing the movement of the swing has asynergistic effect of training the muscle as it builds strength.Similarly, a partial paralytic may regain strength in their hand byholding and writing with a pen configured to transcutaneously deliver astimulating signal.

[0024] Where desired, the instrument may include at least one electrodeconfigured to deliver a stimulating signal to the holder of theinstrument. For instance, two electrodes may be included within the gripof the club or racquet. That is, electrodes may be positioned on theoutside of the instrument so as to contact the hands of the user. Assuch, different parts of a hand and/or different hands will contactelectrodes configured to deliver the signal. In another or the sameembodiment, wired electrodes may extend from the instrument or anadjacent signal generator to the holder of the instrument. Thisconfiguration may allow other, targeted muscles to be concurrentlystimulated while the user manipulates the instrument. The generator ofanother embodiment is contained within or is otherwise attached to theinstrument. As such, the instrument may include batteries and/or a portfor receiving electrical power.

[0025] In any case, the instrument may include a user interface, such asbuttons, dials and/or switches to manipulate the signal. Other userinput devices may include a microphone for use in recognizing voicecommands, as well as a motion sensor. A motion sensor, may, forinstance, activate a signal generation and delivery sequence accordingto the sensed motion of the instrument.

[0026] Features of the present invention may have particular applicationin treating arthritis and diabetes, in addition or in the alternative tostimulating a muscle. Success in these areas may be attributable, inpart, to the manipulation of blood flow enabled by embodiments of theinvention. For instance, an apparatus consistent with the invention mayincrease blood flow according to the signal's travel through amusculature. Other uses of the present invention may extend to the fieldof chiropracty. A method consistent with the invention may provideparticular benefits if used to stimulate a musculature within arelatively short period of time following an injury.

[0027] The above and other objects and advantages of the presentinvention shall be made apparent from the accompanying drawings and thedescription thereof.

BRIEF DESCRIPTION OF THE DRAWINGS

[0028] The accompanying drawings, which are incorporated in andconstitute a part of this specification, illustrate embodiments of theinvention and, together with a general description of the inventiongiven above, and the detailed description of the embodiments givenbelow, serve to explain the principles of the invention.

[0029]FIG. 1 illustrates a block diagram of an apparatus suited forgenerating a signal in accordance with the principles of the presentinvention;

[0030]FIG. 2 shows exemplary signals that may be generated by theapparatus of FIG. 1;

[0031]FIG. 3 illustrates a first user interface suited forimplementation within the apparatus of FIG. 1;

[0032]FIG. 4 shows a second user interface suited for implementationwithin the apparatus of FIG. 1;

[0033]FIG. 5 shows a third user interface suited for implementationwithin the apparatus of FIG. 1 and configured to attach to clothing of auser;

[0034]FIG. 6 illustrates in greater detail the output and polarizingcircuitry block in the apparatus of FIG. 1;

[0035]FIG. 7 illustrates a series of steps suited for execution withinthe apparatus of FIG. 1;

[0036]FIG. 8 illustrates four exemplary signals that may be generatedand simultaneously applied within the apparatus of FIG. 1;

[0037]FIG. 9 shows exemplary pulse shapes generated by the apparatus ofFIG. 1 and suited for incorporation into the signal of FIG. 2;

[0038]FIG. 10 shows resonant sequences that taper in accordance with theprinciples of the present invention;

[0039] FIGS. 11A-C illustrate a muscle contraction sequence inaccordance with the present invention;

[0040] FIGS. 12A-C show a muscle contraction sequence produced by priorart methods and equipment.

DETAILED DESCRIPTION OF SPECIFIC EMBODIMENTS

[0041] An apparatus 10 as shown in FIG. 1 and consistent with theprinciples of the present invention applies resonant sequences of pulsesto the skin of a user in order to induce uniform contractile reactionsthroughout targeted muscle groups. More specifically, the apparatus 10of FIG. 1 applies the resonant sequence of pulses across a targetedmusculature. For purposes of the present invention, a musculature maycomprise a single muscle, as well as some muscle combination or chain.The resonant sequences progress inwardly from the opposite ends of themusculature. The resonant sequences each preferably include at leastthree pulses that are optimally spaced in order to progressively holdand stimulate the bridges of the sarcomeres of the musculature as theytravel toward its center. As such, the resonant sequences create tensionin the musculature inwardly from the electrodes and toward the center ofthe musculature. Significantly, the pulses of the sequences are spacedsuch that their continuous application maintains the tension created inat least a large portion of the musculature by each preceding pulse ofthe resonant sequence.

[0042] In this manner, the musculature is uniformly developed,accounting for patient and athlete balance concerns, and mitigating painassociated with sarcomere stretching, as well as dermal sting associatedwith excessive current. The uniform development of the apparatus 10 isfacilitated by the ability of the resonant sequences to stimulate slowtwitch fibers in a fashion that preserves sarcomere bridges throughoutthe musculature. Because the preservation of the toggled bridgescorrelates closely to processes associated with a natural contraction, auser is spared pain associated with conventional stimulatorapplications. Furthermore, the preservation of tension within themusculature reduces the length and amplitude of applied pulses that mustbe applied to reconstruct a comparable contraction as compared todisjointed pulses of known techniques. As such, the absence of a single,large voltage pulse translates into less discomfort and greateraggregate muscle twitches for the user.

[0043] Furthermore, optimized frequencies of resonant sequences enablethe musculature to distinctly register a succession of pulsecharacteristics within the span of a single contraction. Moreparticularly, the apparatus 10 may vary the width, spacing, polarity,amplitude and/or shape of pulses comprising a sequence to combataccommodation and minimize discomfort. Such variation hinders thenatural tendency of the musculature to adjust to and otherwiseaccommodate the signal, ultimately translating into deeper musclepenetration and decreased discomfort.

[0044] Generally, FIG. 1 illustrates a user interface 11 coupled to astimulator 12 and an associated signal generator 14. A controller 16, orsuitable microprocessor, may receive input generated from the interface11. The stimulator 12 may use the input to configure resonant sequencesoperable to uniformly stimulate targeted muscle groups. To this end, thestimulator 12 may correlate the user input with signal profiles storedin a database 15 resident in a memory 18. As discussed below, eachprofile may embody signal characteristics optimized to uniformlystimulate muscle tissue with less pain and loss due to accommodation,from polarization and/or nutritional depletion.

[0045] As such, the controller 16 may process information extracted fromthe database 15 for the purpose of sending a command to the signalgenerator 14. In response to the command, the generator 14 may create asignal that is conveyed to a user via at least two electrodes 20. Ofnote, a transmission medium suited to convey the signals may comprisemultiple cables or circuits, depending on how many channels are conveyedby the generator to the electrodes 20. Furthermore, as discussed below,an embodiment may incorporate circuitry 13 adapted to manipulate thepolarity of the signal as discussed below in greater detail.

[0046] In response to a command from the stimulator 12 conveying theabove-specified parameters, the generator 14 and/or amplifier may createand transmit a signal to the user via the electrodes 20. Of note, theparameters of the generated signal will correspond to those indicated byuser input. As shown in FIG. 1 and discussed below in detail, thegenerator 14 preferably produces additional, complimentary signals forapplication to additional electrodes 20.

[0047] The electrodes 20 of FIG. 1 may contact the skin of a userproximate to a musculature to be exercised or treated. At least twoelectrodes may be positioned near opposite ends of the musculature. Assuch, applied signals propagate inwardly from the ends of themusculature towards its center. Of note, the apparatus 10 also permitsrelatively distant muscle groups to be exercised as the generated signalpropagates throughout the body from the electrodes 20. Accordingly, thesignal transmitted via the electrodes penetrates and stimulates thevarious tissues of surrounding muscles according to the generatedsignal. FIG. 2 illustrates an exemplary signal that may be generatedwithin the environment of FIG. 1.

[0048] The signal may convey a series of resonant sequences as shown inFIG. 2. As discussed below in detail, suitable strings of sequences maybe distinct and/or mirror/complement each other as prescribed by a givenapplication. Furthermore, the number, width, amplitude, frequency andshape of each pulse of a resonant sequence, or of a resonant sequence,itself, may be selectively modified to achieve a desired effect. Eachsequence will preferably include at least three pulses. The frequency ofthe resonant sequences communicated via the electrode may rangegenerally from about 1 to about 4 kHz. Although the number of pulses maybe separately adjustable, such a configuration preferably allows forabout 1 to about 100 pulses per second. A single resonant sequence maylast for about 6-90 milliseconds. Of note, comparable, conventionalpulse frequencies and widths would quickly exhaust the nutrition andskew the electrical balance of a muscle, thus promoting accommodation.As such, the muscle would become unresponsive after only a few pulses,and the patient would likely experience a dermal stinging sensation.

[0049] The exemplary signal of FIG. 2 accounts for such conventionalobstacles, in part, by interjecting downtime 25 on the order of about 5to about 500 milliseconds between resonant sequences 30, 32, 33, 35.Such preprogrammed periods 25 of rest enable muscle tissue to replenishenergy expended during the prior twitch or contractile advance. Asdiscussed below in detail, the stimulator 12 of FIG. 1 may vary thewidth, frequency, polarity and/or amplitude of each sequence 30, 32, 33,35 shown in FIG. 2 as needed to facilitate penetration. Further, theresonant sequences 30, 32, 33, 35 may be evenly or irregularly spacedfrom one another to combat accommodation and promote deepercontractions.

[0050] Individual pulses embedded within each resonant sequence 30, 32,33, 35 of FIG. 2 further contribute to the stimulation and recovery ofdifferent layers of musculature. Configurable characteristics of thepulses provide a mechanism for combating nerve boredom, and nutritionalstarvation as sources of accommodation while still achieving a thresholdpotential with less charge and associated pain over a larger number andspread of sarcomeres. As discussed above, threshold potential refers toa minimum charge required to initiate a twitch, that is to say, atoggling of one or more bridges in the affected sarcomere leading up toa contractile reaction. Significantly, each pulse of a resonant sequencemay preserve and reinforce sarcomere bridges as the pulse propagatestowards the center of a musculature. Such preservation of tension cantranslate into more natural, deep and uniform contractions as explainedbelow.

[0051] FIGS. 11A-C illustrate an exemplary sequence of such acontraction that is consistent with the principles of the presentinvention. That is, the sequence shows the propagation of resonantsequences traveling inwardly from poles 180 of a muscle 182. Forpurposes of FIGS. 11A-C, the resonant sequences arrive from a stimulator12 via electrodes 20 positioned proximate the poles 180. As such,bridges in sarcomeres 184 closest to the poles 180 of the muscle 182flex, or toggle, in response to a first pulse of a resonant sequence asillustrated in FIG. 11A. Thus, tension is initiated in extreme portions186 of the muscle 182 near the poles 180 as the pulse travels inwardly.Assuming that all pulses have the same rise time, that is to say, thesame slewing rate, any pulse will start with the same reaction as shownin 11A and 12A. The longer it remains, the more of the cycle depicted in12A-C is completed until it can respond no longer, untoggles and becomesunresponsive.

[0052] To further illustrate significant advantages realized by anembodiment of the invention, the resonant sequence-induced musclecontraction of FIGS. 11A-C is concurrently contrasted against a reactioncaused by a single pulse that is long enough to affect a whole muscle ormusculature. As shown in FIG. 12A, the reaction initiated by the pulseis nearly identical to the muscle activity of FIG. 11A as theconventional pulse toggles sarcomeres 194 near the electrodes 202.However, superior contractile response and other advantages achieved bythe stimulator 92 of FIGS. 11A-C become more apparent as respectiveresonant sequences travel inwardly from the electrodes 20.

[0053] Lead pulses of resonant sequences of FIG. 11B propagate towardeach other from the electrodes 20. The sequences initiate toggling ofsarcomeres 184 resident in intermediate portions 188 of the muscle 182.Of note, electrical variation in the polarity of the arriving pulsesheighten the twitching reaction of the intermediate portions 188 ascompared to prior art applications, where accommodation may mitigatecontractile response as shown in FIG. 12B. Significantly, the arrival ofa second pulse of the resonant sequences of FIG. 11B at the poles 180has the affect of sustaining bridges initiated by the first pulse withinthe extreme portions 186.

[0054] That is, the second pulse may be spaced from the first by adistance optimized such that the second pulse reinforces and maintainstoggling in the extreme portions 186 as the second pulse creates similartension in the intermediate portions 188. More particularly, the pulsesmay be spaced at around 3,500-7,000 microseconds. As it may take 10,000microseconds for sarcomere 184 bridges to toggle off, the prior arrivalof the second pulse preempts such bridge disconnection. Of note,variation in pulse characteristics discussed herein facilitate suchresponse by mitigating dampening affects associated with accommodation,as well as electrical and nutritional depletion.

[0055] In contrast to the sustained toggling of the extreme portions 186as discussed above in the text accompanying FIG. 11B, comparable areas186 of the muscle 190 of FIG. 12B return to a relaxed position over thesame period. The prior art application of FIG. 12B may succeed intoggling intermediate portions 198 of the muscle 190, but such bridgingis accompanied by an absence of tension in the extreme areas 196. Thus,the inability of the conventional pulses to maintain toggling near theelectrodes 202 results in tension traveling arrhythmically across themuscle 190 of FIG. 12B, defeating a uniform contraction.

[0056] This critical distinction between the present embodiment andprior art applications is further accentuated in FIG. 11C, wheresubsequent, third pulses of applied resonant sequences continue tosustain sarcomere 184 bridges near the poles 180 as second pulsespropagate to the intermediate portions. FIG. 11C shows such a scenarioas both second and third pulses maintain tension within their respectivemuscle portions 188, 186. In this manner, tension is simultaneouslymaintained throughout the extreme and intermediate portions 186, 188 ofthe muscle 182 as the first pulses continue to propagate towards thecenter 190 of the muscle 182. Sarcomeres of the center 190 bridge tofacilitate a uniform contraction across the entirety of the muscle 180.Of note, such uniformity evades the prior art application of FIG. 12C inthat only the center portion 200 of the muscle 190 toggles while theintermediate 198 and extreme 196 portions relax.

[0057] In contrast, FIG. 11C shows the sarcomeres of the center portion190 creating strong bridges in response to the first pulses of theresonant sequences. Significantly, all portions 186, 188 and 190 of themuscle 182, or musculature may be uniformly and simultaneously toggled.This feature is enabled by the optimized spacing and pulse variation ofthe resonant sequences, which are configured to mitigate nutritional andelectrical exhaustion that frustrate prior art attempts to comparablecontractile reactions. Such uniform stimulation can translate into morenatural and deeper (resonant) contractions. Furthermore, the uniformityobviates much of the pain conventionally associated with sarcomerestretching. As discussed below in detail, variation of the pulsecharacteristics facilitates sustained sarcomere bridges enabling theuniformity shown in FIG. 11C by accounting for accommodation. Of note,additional pulses may be applied via the electrodes to further enhanceuniformity as the contractile reaction propagates inwardly throughoutthe muscle 182 or musculature.

[0058] As such, a user may select a number of pulses at block 11 of FIG.1 that will comprise a resonant sequence. As shown in the exemplary userinterface 11 of FIG. 3, an operator may manipulate a dial 112 to specifyhow many pulses the generator 14 of FIG. 1 will include within anexemplary sequence having around a 7.6 millisecond span. Of note, apreferable setting for most healthy patients may comprise between fourand seven pulses. The stimulator 12 of FIG. 1 may set the voltage ofeach selected pulse to account for pulse number and duration.Alternatively, the user may manually adjust voltage using dial 114 ofthe interface 11 of FIG. 3 to a setting preferably ranging from about 1to about 150 volts. Of note, such range is merely exemplary and may beincreased substantially in special cases, such as with a denervatedpatient.

[0059] In this manner, the interface 11 allows a user to optimize thenumber of pulses comprising a sequence such that sarcomere bridges ofthe musculature are maintained at the extremities of the musculature assubsequent pulses propagate toward its center. That is, while theresonant sequence is configured to induce only one, uniform contraction,the musculature may nonetheless register individual polarities and otherparameters of the pulses of the sequence. As such, the individualcharges of each pulse may evenly accumulate an aggregate charge acrossall tissues of the musculature. In this manner, the reinforced andevenly distributed bridges of the sarcomere provide a series of twitchessufficient to drive the contractile reaction. The absence of a largespiking voltages and muscle stretching associated with uneven musclecontraction achieves a more thorough contraction without the pain oftenassociated with such conventional pulse trains.

[0060] The user may further optimize the number of pulses selected atthe interface 11 of FIG. 3 to uniformly address different muscle typesas the signal propagates throughout the body of the user. For instance,a resonant sequence containing four to seven pulses may incorporate asufficient number of pulses to progressively stimulate the length of amusculature without overstimulating fast twitch tissue. As such, anoperator may accordingly adjust a dial 112 and corresponding number ofpulses in a sequence. Additionally, the pulses spacing between theselected number of pulses promotes a deep contraction in slow twitchtissues affected by the same signal. In this manner, the embodimentuniformly accommodates the different sensitivities of muscle groups.

[0061] Thus, a patient and/or technician may configure all of thepulse/sequence characteristics discussed herein via the exemplary userinterface 11 of FIGS. 1 and 3. For instance and as discussed below indetail, an operator may adjust another dial 117 to determine thefrequency of pulses associated with a signal. Most treatmentapplications preferably require anywhere from about 25 pulses per secondto about 70 pulses per second. Another dial 113 may proportionallycontrol the intensity or voltage associated with a signal relative to asecond, simultaneously and proximately applied signal. As also discussedbelow, an operator may adjust the polarity and rest periods in betweenresonant sequences via dials 116 and 115, respectively.

[0062] Features of the interface 11 configured to receive input maycomprise a series of dials as shown in FIG. 3. In the alternative, acombination of switches, keyboard, touch screen/pad, buttons, modem,microphone, or any other known input mechanism may be employed.Alternatively or in addition, a suitable user interface 11 may placelittle or no physical demands on a user. For instance, an exemplaryinterface 11 of FIG. 1 may include voice recognition software, orincorporate handles or pedals that may be manipulated by merely bumpingor squeezing.

[0063] For instance, exemplary handles 118 comprising the interface 11″of FIG. 4 may be manipulated by a user to control stimulator functions.As such, the user may grip orient, or contact the handles in such amanner as to affect the voltage, frequency and rest periods associatedwith resonant sequences. For instance, a user may reverse the polarityof resonant sequences by tapping opposite ends 143 and 144 of thehandles 146 together. Such action may reduce stinging of the skin thatmay be associated with applications of uniform polarity. Anotherembodiment may interpret the same action as a request from the user toincrementally increase voltage. Conversely, tapping opposite ends 145and 147 may cause a decrease in voltage. Contacting all four ends 143,144, 145, 147 of the handles 146 may initiate a period of rest for theuser, temporarily halting transmission of the stimulating signal. Otherparameters, such as package rate and channel balance may be accessibleto the user by contacting respective bottoms 144, 147 of the handles 146together. Such contact may alternatively or in addition, change a modeof the application, altering command/contact sequences of the handles146 to allow for the adjustment of additional parameters.

[0064] Another embodiment illustrated in FIG. 5, shows a batteryoperated user interface 11″ configured to fit within a pocket orotherwise attach to the clothing of a user. As with the larger,stationary embodiment shown in FIG. 3, the user interface 11″ of FIG. 5incorporates multiple dials 161-164 with which the wearer may adjuststimulator settings. More particularly, dial 161 may communicaterequired voltage levels to the stimulator, preferably ranging from afraction of 1 volt to about 150 volts. Dial 162 may adjust, or balance,the relative voltage as applied between respective channels leavingports 165, 166 of the interface 11″.

[0065] In this manner, the interface 11″ facilitates stimulatingdifferent muscle groups according to tailored voltage levels. Dial 163may control the frequency of pulses generated by the stimulator, anddial 164 may interject a proscribed ratio of rest periods betweenresonant sequences. Of note, dials 161-164 are merely exemplary andcould each be substituted or augmented with any number of functionscontrolling features of a stimulating signal, to include phasicmodulation and/or waveform shapes. Also, the self-contained and portablenature of the user interface 11″ enables a wearer to receive treatmentwhile traveling, working or exercising.

[0066] A user interface of another embodiment may incorporate ahysteresis loop configured to monitor contractile, diagnostic or otherpatient/user reactions and automatically adjust signal generation,accordingly.

[0067] For instance, the a sensor monitoring the heart rate of a patientmay cause the stimulator 12 of FIG. 1 to step down voltage or interjecta rest period in response to detecting an elevated rate. Morever, asuitable user interface may enable both the user and the operator toaccess the interface. As such, the feature allows an athlete or patientto adjust signal charge and other parameters of the stimulator signalper their own tolerance levels and unique fitness goals.

[0068] Of note, the inclusion and optimization of pulses at the userinterface 11 of FIG. 1 further mitigates the effects of nutritionaldepletion and accommodation. In addition to initiating and sustainingsarcomere bridges throughout the musculature, the optimized spacingbetween each pulse further allows the musculature to perceive othercharacteristics of each pulse. As discussed below in detail, an operatormay access the interface 11 to vary such pulse characteristics aspolarity, amplitude, width and/or spacing as between pulses to realizeadditional benefits. For instance, such variation may limit thedetrimental effects of accommodation on the sarcomere level. Ideally,the body will not have time to adjust between different characteristics,and a deep level of penetration may be maintained. Rest periods inbetween pulses may allow the musculature time to recalcify and replenishATP, as well as electrically reset.

[0069] Another benefit realized by the pulse configuration feature ofthe interface 11 of FIG. 1 concerns patient discomfort. As discussedbelow, the variation of polarity as between respective pulses andsequences may be made to equalize each other where desirable, decreasingthe occurrence of stinging surface sensation. Additionally, since thecharge of each pulse of a given resonant sequence is relatively low, theapplied signal does not subject the musculature to a single, largecharge pulse of a type conventionally associated with pain. In thismanner, the resonant sequence achieves a cumulative, high voltage chargewithout the detrimental side effects associated with a conventionalsingle pulse.

[0070] In response to the user selecting the number of pulses comprisinga resonant sequence, the stimulator 12 of FIG. 1 may automaticallymanipulate the polarity of respective pulses within a resonant sequence.For instance, the controller 16 may retrieve from memory 18 a polarprofile, or template, that corresponds to the designated number ofpulses. As such, the polar profile associates a preprogrammed polaritywith each pulse of the resonant sequence. Within a given polar profile,a portion of the pulses may have a negative polarity, while theremainder exhibit positive characteristics.

[0071] The exemplary signal of FIG. 2 demonstrates such variation withineach resonant sequence. For instance, the polarity of first 22 andfourth 24 pulses of a first resonant sequence are intermixed with pulses26-28 of opposing polarity. Variation in polarity serves to break upaccommodation in that change hinders the ability of the body to adjustto the pulses. Thus, the stimulator 12 of FIG. 1 adjusts polarity inresponse to input from the user interface 11 to enable greaterpenetration for subsequent pulses of a resonant sequence.

[0072] As shown in the interface 11 of FIG. 3, the user may further beprompted to alter the polarity of an entire resonant sequence. Forinstance, a user may turn a dial 116 on the interface 11 to select anumber of consecutive resonant sequences to be generated before asequence having opposite polarity is presented. The exemplary signal ofFIG. 2 has two resonant sequences 30, 32 that are polar opposites ofeach other. In this manner, the settings of the interface 11 of FIG. 3provide at least two layers of phasic variation (at both the pulse andresonant frequency levels) to promote deep muscle contraction and limitsurface stinging.

[0073] The controller 16 of FIG. 1 additionally executes program code 17configured to manipulate the cumulative polarity of the resonantsequences of a signal. That is, a program 17 may mathematicallymanipulate the order and number of resonant sequences within a signal toachieve a desired balanced or net charge. For instance, the controller16 may repeat, insert and delete resonant sequences to ensure a desiredproportion of total signal charge is oriented at a specific polarity. Assuch, the controller may minimize surface charge and associated stingingby achieving a balanced charge.

[0074] Alternatively, the program 17 of FIG. 1 may configure resonantsequences so as to induce a uniform flow of electrical charge. Such anet charge may be appropriate where the operator wishes to open orconstrict targeted blood vessels. Similarly, the program may employ anet charge to squeeze or otherwise influence the function of lymph nodesor veins. As such, a suitable user interface 11 of FIG. 1 may includefour settings. One such setting of the interface 1 may include a firstcontrol for normal charge distribution. A second, exemplary setting maycorrespond to a moderately unbalanced, net charge. More extremeapplications, such as may be appropriate for some denervated patients,call for gross unbalancing, or even uniform polarity.

[0075]FIG. 6 shows an exemplary circuit suitable for implementingpolarizing circuitry 13 of FIG. 1 in such a manner as to prevent a pulsefrom overshooting zero voltage upon its termination. An inability toregulate polarity as such otherwise results in a net electricalimprecision. As shown in FIG. 6, such polarity may be facilitated bypolarizing circuitry 13 comprising switching transistors 90, 92 andoptical diodes 102, 104 configured to regulate current flow in onedirection.

[0076] More particularly, a signal transmitted from the generator 14arrives at the polarizing circuitry 13 via lines 87. As discussed below,the signal conveys its own series of resonant sequences tailoredaccording to user input. For efficiency and hardware consideration, thevoltage associated with the signal remains relatively low when leavingthe stimulator. Consequently, the voltage associated with the signalmust be increased prior to transcutaneous application at an electrode20. To this end, the signal passes through a switching transistor 90 toa transformer 94.

[0077] The transformer 94 steps up the voltage of the signal accordingto a voltage command transmitted from the generator 14 via line 96 andamplifier 98. The voltage command operates to apply voltage to thetransformer 94 and thus affect how much the voltage of the signal isstepped up. The voltage signal from the generator 14 may correlate touser input, for instance, dialed-in to the intensity setting 114 of FIG.3. This feature enables the magnitude of pulses to be varied accordingto therapeutic protocol and user tolerance. For instance, a user mayvary voltage of a pulse between about 1 and about 150 volts.

[0078] The switching transistor 90 may continue to relay the signal tothe transformer 94 so long as voltage presented at its gate remainsabove a threshold voltage associated with the transistor 90. Should thevoltage presented by the signal at the gate fail to achieve thethreshold level, then the transistor 90 will become unsaturated and thevoltage signal will drain to ground. Subsequently, no signal will bepresented to the transformer 94 for that period where voltage remainsbelow the threshold level. Of note, the threshold level and signalvoltage may be coordinated such that signal will present a voltage atleast equaling the threshold level at a point of a resonant sequencecorresponding to a pulse. Thus, the binary nature of the switchingtransistor 90 configuration may ensure that only voltage associated withpulses is passed to an electrode 20.

[0079] In this manner, the transformer 94 steps up the voltageassociated with the pulse signal 87 prior to shaping it with anopto-isolator 100 and rectifying diodes 104. Absent such provision,transformer output would oscillate and swing above zero voltage at theterminal ends of each pulse. Such imprecision could negatively affectaggregate charge related to a user via the electrode 20. Consequently,the opto-isolator 100 receives the stepped up signal and acts as anotherlayer of polar filtration.

[0080] More particularly, an LED 103 of the opto-isolator 100 emitslight in response to detecting current conveyed by the signal. A lightsensing device 101 of the opto-isolator 100 detects the illumination andsends a signal to a rectifying diode 104, which further ensures theuniform and intended polarity of the signal. Thus, these components actin tandem to clip transformer output at the terminal end of a presentedpulse. While the inclusion of the opto-isolator 100 obviates arequirement for an electrical connection and associated ground loops, itshould be understood by one of ordinary skill that their functionalitycould be replaced by switches and relays. Of note, the circuitry 13 ofFIG. 6 makes allowance for two different signals, transmitted over lines87 and 88. As such, the exemplary circuitry 13 provides a secondopto-isolator 105 configurable to communicate current and flow to asecond rectifying diode 102 prior to transcutaneous application to theuser via electrode 20′.

[0081] Likewise, the apparatus 10 of FIG. 1 enables the simulator 12 tosimultaneously apply different resonant sequences to a muscle and/ormuscle group. For instance, the generator 14 may retransmit the originalsignal to a second electrode 20. As discussed above, the electrodespreferably apply their associated signals near respective ends of themusculature. Alternatively, the stimulator 12 may initiate thetransmission of some phasic variant of the original signal to the secondelectrode 20. The generator 14 may transmit the additional signals insuch a manner as to realize interactive or synergistic effects betweenthe signals discussed detail in below. As such, at least two signals maybe proximately applied and synchronized such that the combinedapplication emulates a single pulse having a width that exceeds theparameters of a conventional transformer.

[0082] This feature enables an operator to tailor pulse frequencytowards holistic muscle development. For instance, one embodiment of thepresent invention has particular application when attaching electrodes20 of FIG. 1 at extremities. The highest concentrations of fast twitchmuscles are generally in the extremities to provide speed and finecontrol to the hands and feet. As discussed above, fast twitch musclesreact quickly to individual pulses of a resonant sequence. The pulsespacing within a resonant sequence allows the fast twitch muscle torecover in between pulses in manner that avoids overstimulation andnutritional depletion. The optimized spacing of the pulses of an appliedresonant sequence further enables the formation of sarcomere bridgeswithin slow twitch fibers of the muscle. Thus, charges of the individualpulses affect twitches uniformly throughout the musculature.

[0083] The sustained bridges of the sarcomere are accommodated byvariation in pulse characteristics that register within the musculature.More particularly, variation in pulse polarity, width, amplitude andspacing can combat accommodation and enable greater penetration withless discomfort. As such, a signal applied to the hand of a user mayseem comfortable to the fast twitch muscles of the carpal tunnel andforearms, while simultaneously stimulating the upper muscles of theupper arm and chest. Similar applications may be realized with therespective fast and slow twitch muscles of the feet and legs of a user.In this manner, the apparatus 10 capitalizes on the natural timing ofmuscle processes.

[0084] Of note, while the invention has and hereinafter will bedescribed in the context of a stimulator, controller, computer or otherprocessor, those skilled in the art will appreciate that the variousembodiments of the invention are capable of being distributed as aprogram product in a variety of forms, and that the invention appliesequally regardless of the particular type of signal bearing medium usedto actually carry out the distribution. Examples of signal bearing mediainclude but are not limited to recordable type media such as volatileand non-volatile memory devices, floppy and other removable disks, harddisk drives, magnetic tape, optical disks (e.g., CD-ROM's, DVD's, etc.),among others, and transmission type media such as digital and analogcommunication links.

[0085] Morever, various programs described herein may be identifiedbased upon the application for which they are implemented in a specificembodiment of the invention. However, it should be appreciated that anyparticular program nomenclature that follows is used merely forconvenience, and thus the invention should not be limited to use solelyin any specific application identified and/or implied by suchnomenclature.

[0086] The flowchart of FIG. 7 illustrates sequence steps suited forexecution within the system hardware environment of FIG. 1. Namely, theexemplary steps are suited to generate a resonant sequence in accordancewith the principles of the present invention. As discussed above, eachresonant sequence preferably contains at least three pulses. RegardingFIG. 3, the stimulator may select the number of pulses included within asequence at block 50 in response to user input.

[0087] As such, each resonant sequence will include periods of rest inbetween pulses. After each pulse of a resonant sequence, a musculaturemay require a period of time to replenish some of the ionized calciumand ATP's lost in reacting to the preceding pulse of the resonantsequence. This replenishment enhances the strength of the next twitchand breaks up accommodation in the sarcomere and fibril levels. Thenumber of pulses comprising a sequence can further be optimized topropagate a contractile reaction across a musculature while sustainingtension throughout. The number of pulses may additionally influence theextent to which the musculature is stimulated by the generated signal.This consequence is a product of how different muscle groups react tostimuli.

[0088] For instance, a fast twitch muscle of a musculature may react toevery pulse within a resonant sequence. As such, the number of pulses ina sequence may be set at block 50 according to a number or frequencythat does not result in excessive downtime in between pulses. Suchprecaution helps avoid painful jerking reactions and under stimulationin fast twitch muscles. Because a slow twitch muscle can not respond asquickly to the potentials of high frequency pulses, care is taken toconfigure pulses so as to compliment the natural, harmonic frequency ofthe slow twitch muscle.

[0089] For instance, while a resonant sequence containing over eightpulses may be too fast to register with the slow muscle, a smaller,optimized number of pulses within a sequence may achieve a resonantaffect. That is, the charge of the pulses initiates and sustainsbridging of sarcomeres throughout the musculature leading to a single,synergistic pulse. Of note, care is taken not to overload the fasttwitch muscles. As such, the fast twitch muscles have time to recover inbetween pulses, translating into decreased tension and pain. As withmany of the settings addressed herein, the number of pulses in aresonant sequence required to achieve a maximum harmonic affect may varyaccording to the condition and tolerance of the user. For instance, apatient with severe muscle denervation may tolerate over seven pulseswithin a resonant sequence. In many cases, however, the four to sevenpulses per burst demonstrates optimum results.

[0090] Having used the interface to specify the number of pulses atblock 50, program code executed by the controller may assign a polarprofile to the resonant sequence at block 52. Namely, the controller mayassociate the requested number of pulses with a polar profile ortemplate maintained within the database. As such, the polar profileassociates the requested number of pulses with predetermined polarities.The database may store multiple combinations of such polar profiles foreach pulse count. As discussed above, polarity may vary to combataccommodation, as well as to adjust net charge. Alternating polarity canfacilitate maintaining tension across the musculature, as the featurecan mitigate the affects of accommodation that could break sarcomerebridges or necessitate more voltage.

[0091] Having varied the polar sequences of pulses within a singleresonant sequence at block 52, the stimulator may alter the polarity ofeach resonant sequence at block 54. More particularly, an operator mayspecify the number of resonant sequences generated before the polarityof a resonant sequence or group of resonant sequences is inverted. Forinstance, a user interface may prompt an operator to specify that thepolarity of resonant sequences should be reversed after every threesequences. As above, changes in polarity can mitigate the effects ofaccommodation. Absent such variation, a musculature may begin to adaptto a repeated pulse pattern after a few cycles, compromisingpenetration. By reversing the polarity of the resonant sequence, amusculature may perceive the inverted resonant sequence as being anentirely distinct resonant sequence. As such, a musculature that hasadjusted itself to accommodate a given resonant sequence may nonethelessreact to the same sequence with reverse phasing. In this manner, thestimulator provides layers of phasic variance at both the pulse andresonant sequence levels.

[0092] At block 56 of FIG. 7, the stimulator may vary the order ofinverted resonant sequences to obtain mathematical consistency withregard to phasing and pulse length. The goal of the manipulation mayinclude realizing a balanced or desired net charge. For instance, thecontroller may mathematically manipulate resonant sequences to ensure adesired proportion of signal charge is oriented at a specific polarity.In most cases, the controller will repeat, insert and delete resonantsequences to realize a balanced charge, minimizing surface charge andassociated stinging.

[0093] In another application at block 56, an operator may desire toinduce a uniform flow of electrical charge. Such a net charge may beappropriate where the operator wishes to open or constrict targetedblood vessels. Similarly, the stimulator may employ a net charge tomanipulate the function of lymph nodes and the contractions of localizedcells. As such, an exemplary user interface may include four settings.For instance, suitable settings of an interface may include one fornormal distribution and a second setting configured to promote minorunbalance. More extreme applications may call for a grossly unbalancedcharge, or even uniform polarity.

[0094] The stimulator may then generate a first signal at block 58 inaccordance with the specified resonant sequence parameters. As such, thesignal may be transmitted via the electrode to the musculature.Preferred applications may call for the generation of additional signalsat block 58. The stimulator may employ the additional signals in such amanner that a synergistic or compound effect is realized. For instance,the coordinated charge of two proximately applied signals can emulate asingle, longer pulse. Of note, the pulse width and voltage realized bysuch a configuration may exceed that available via a single generatingtransformer. As such, the dual signal feature can overcome equipmentlimitations to achieve greater muscle penetration. As discussed below,additional compounding and harmonic effects may be achieved bysimultaneously applying multiple signals.

[0095] To this end, the controller may reuse the profile used torecreate the original signal at block 58. As such, the generator maytransmit the original signal to a second electrode at block 58.Alternatively, the generator may initiate the transmission of somephasic variant of the original signal to the second electrode. Anexemplary user interface configured to account for such phasic variationmay include a dial, touch pad or other mechanism configured to selectfrom among different signal generation schemes.

[0096]FIG. 8 illustrates three exemplary signals that may be applied tothe user in conjunction with an original signal 80. More particularly,the exemplary in-phase application 82 of FIG. 8 may be applied to a uservia a second electrode placed proximate to the first, which conveys theoriginal signal 80. As such, the in-phase signal 82 mirrors the resonantsequences of the original channel 80. In this manner, signal strength isreinforced as both channels propagate throughout the user. A thirdchannel 84 may duplicate the original signal 80 beginning at the end ofthe first pulse 85 of the original 80. Still a fourth application maycause each pulse of the resultant signal 86 to initiate at the end ofeach pulse of the original signal 80. A musculature may perceive such anapplication as having seamless pulses of twice the width of the originalpulse 80. Such a design can have particular application where denervatedpatients require pulses of greater width than are available viaconventional transformers.

[0097] All three signals illustrated in FIG. 8 are appropriate fortherapeutic application, two signals 84, 86 further facilitate musclegrowth. Of note, the order in the which the channels are transmitted mayvary relative to one another. For instance, one application may call foran original signal 80 transmitted via a first electrode to be followedby the out-of-phase signal 84 emanating from a second electrode. Toachieve greater muscle penetration, the controller may reverse therelative order of the signals such that the original signal 80 executesin succession to the other 84. This feature represents yet another layerof variation available to overcome accommodation.

[0098] In this manner, the changing phasic relationship of two signalsmay combine to generate deeper muscle contractions with less associatediscomfort. That is, the body will not have time to adjust to or bracefor changes in the signal sequence. Consequently, applied charges neednot be increased to maintain constant levels of stimulation. Becauseapplied charge can be proportional to patient discomfort, the stimulatorenables more contractile reaction with less pain. As discussed above,the exemplary user interface 11 of FIG. 3 may further allow a user toadjust the relative strength of two signals in proportion to each other.

[0099] As may be appreciated, the inclusion of additional signals canrealize still further penetration and additional sub-harmonics. Forinstance, the stimulator may simultaneously employ three signals todifferent electrodes. The controller may further redirect respectivesignals to different electrodes and corresponding muscle groups. Such anapplication may promote balanced muscle development while breaking upaccommodation.

[0100] Also of note, the flexible interface and electrode configurationof the above described embodiment may enable an athlete or patient toperform athletic or therapeutic motions while the stimulatorconcurrently exercises the musculature. As such, an operator may limitapplied electrodes to a number sufficient to avoid encumbering theathlete from accomplishing a desired range of motion. For instance, auser may simulate an arm swing appropriate for a tennis racquet,baseball bat or golf club while electrodes on the swinging armcommunicate muscle building signals. This feature enables a musculatureof the athlete to be stimulated at different stages of contraction,translating into more balanced muscle development and training.

[0101] Returning to FIG. 6, the stimulator may manipulate the shape ofeach pulse at block 60 to capitalize on the manner in which nerves ofthe body react to stimuli. For instance, FIG. 9 shows a conventionalsquare pulse 70 that the may be generated in accordance with theprinciples of the invention. Such a square pulse 70 may have particularapplication where a user requires relatively more rest in between pulsesto replenish lost resources. FIG. 9 additionally illustrates anotherpulse formation 72 available for generation within the confines of thepresent embodiment. As shown in the figure, the trailing edge of thepulse 72 exemplifies faradic characteristics. That is, the trailing edgeof the pulse lingers and trails off.

[0102] This trailing, or faradic feature shown in FIG. 9 causes thepulse 72 to more gradually discharge throughout the musculature in amanner analogous to that of a capacitor in a circuit. In fact, oneembodiment may cause a transistor to discharge an actual capacitor intothe skin of the user in response an absence of current in order to formthe pulse 72. A resistance circuit may further contribute to the naturalresistance of the skin to facilitate voltage bleed off. Alternatively, agenerator or transistor may be tasked to form a faradic wave at lowvoltage. Such a waveform may be amplified at output.

[0103] A sensory nerve processing a pulse 72 of FIG. 9 produced in sucha manner may perceive the immediate portion of the trailing edge asconstituting the end of the signal. This feature may serve to relax andcalm the sensory nerve, diminishing the occurrence of muscle tightening.Significantly, a motor nerve reacting to the same pulse 72 may continueto react to the trailing portion of the pulse 72. In this manner, theembodiment extends the period of work affecting the musculature withoutunduly taxing sensory nerves.

[0104] Significantly, the decaying pulse 72 of FIG. 5 is more like whatthe body naturally produces than the conventional square pulse 70. Suchcharacteristics are desirable because nerve fibers make for relativelypoor conductors absent the natural, active processes of the muscle.Consequently, emulation of natural impulses realized by the pulsesculpting feature of block 60 of FIG. 7 invokes natural processes andpromotes current flow at lower voltages. As such, applied charges mayalternatively be increased to achieve deeper contractions. Of note, bothtypes of pulses shown in FIG. 9 can be used in tandem to vary stimuliand overcome accommodation.

[0105] In nature, signals from the brain taper to allow replenishmentand enhance the strength of a next occurring twitch. Acknowledging thisphenomenon, the stimulator at block 62 of FIG. 7 may shorten the widthof successive pulses of a resonant sequence as a muscle tires. Forinstance, the duration of pulses included in resonant sequences 81, 83,85 of FIG. 10 gradually taper on the order of ten to twenty percent. Thewidth of successive pulses of resonant sequence 30 of FIG. 2 similarlywane. In this manner, a musculature perceives the decaying signal asbeing more like those naturally produced by the body.

[0106] The shortened pulse width will also decrease pain at the fascicletissue level. Of note, this feature enables contractile responses atlower charge levels. Consequently, the stimulator may operate at chargelevels that induce less pain in a user. As such, the feature allows auser to comfortably increase charge to allow greater penetration andovercome accommodation. Similarly, width may vary as between consecutiveresonant sequences to achieve other comfort and therapeutic benefits.Furthermore, one skilled in the art should recognize that the order ofpulses of varying width, shape or magnitude need not require one pulesto immediately follow another, any sequence of like and dissimilarpulses may be generated in accordance with the principles of the presentinvention.

[0107] Despite the rest periods and other provisions built-in to thegenerated signal, certain users may require additional rest to morethoroughly replenish lost ATP and ionized calcium. Consequently, oneembodiment may include a rest-on-demand function. As such, a user maymanipulate the interface 11 of FIG. 1 to pause the transmission ofsignals to the electrode(s). For example and as discussed above in thetext accompanying FIGS. 3-5, a user may bump a handle 118 or petalconfigured to temporarily cease transmission in response to contact.

[0108] Of note, because generated signals of the embodiment balanceelectrical polarities and replenish lost resources continuously, themusculature may require only a few seconds of rest to completelyrecover. Furthermore, such short rest periods may be preprogrammed intoa treatment or training protocol. Of note, one embodiment slowly rampsup the voltage following a such downtime to facilitate a gradual,relatively painless transition.

[0109] It will be appreciated that the generation of the variousresonant sequence profiles and associated pulse shapes discussed hereinmay be implemented using hardware and/or software to store and/orgenerate the appropriate profiles and shapes, and that suchimplementations would be within the abilities of one of ordinary skillin the art having the benefit of this disclosure.

[0110] While the present invention has been illustrated by a descriptionof various embodiments and while these embodiments have been describedin considerable detail, it is not the intention of the applicants torestrict or in any way limit the scope of the appended claims to suchdetail. For instance, one embodiment that is consistent with theinvention may include a therapeutic or developmental instrument thatincludes hardware and/or software for stimulating a muscle. Such aninstrument may comprise, for instance, a golf club, a baseball bat, alacrosse stick, a tennis racquet or a hockey stick, among othersports-related instruments. Still other suitable instruments may includea writing instrument, such as a pen. In the case of a golf club, amuscle of a user may be stimulated by the instrument as the golferpractices her swing. Combining such muscle stimulation with the act ofpracticing the movement of the swing has a synergistic effect of‘training’ the muscle as it builds strength. Similarly, a partialparalytic may regain strength in their hand by holding and writing witha pen configured to transcutaneously deliver a stimulating signal.

[0111] Where desired, the instrument may include at least one electrodeconfigured to deliver a stimulating signal to the holder of theinstrument. For instance, two electrodes may be included within the gripof the club or racquet. That is, electrodes may be positioned on theoutside of the instrument so as to contact the hands of the user. Assuch, different parts of a hand and/or different hands will contactelectrodes configured to deliver the signal. In another or the sameembodiment, wired electrodes may extend from the instrument or anadjacent signal generator to the holder of the instrument. Thisconfiguration may allow other, targeted muscles to be concurrentlystimulated while the user manipulates the instrument. The generator ofanother embodiment is contained within or is otherwise attached to theinstrument. As such, the instrument may include batteries and/or a portfor receiving electrical power.

[0112] In any case, the instrument may include a user interface, such asbuttons, dials and/or switches as described herein to manipulate thesignal. Other user input devices may include a microphone for use inrecognizing voice commands, as well as a motion sensor. A motion sensor,may, for instance, activate a signal generation and delivery sequenceaccording to the sensed motion of the instrument.

[0113] In another embodiment, electrodes consistent with the presentinvention may be included within garments worn by the user. Forinstance, electrodes may be positioned or otherwise included on aninner, outer and/or interior surface of a glove, uniform, shoe, sock,vest, sleeve, shirt, hat/helmet, brace, suspender, eye wear, pad,jewelry, watch and/or pants of the user. Such electrodes may beinterwoven or configured for attachment to such apparel so as tocommunicate signals to a musculature as discussed above. Such signaldelivery may include signals generated while a user is walking, swingingor otherwise practicing physical movement. In this manner, targetedmuscles are concurrently stimulated while the user wears the garment(s).The generator of an embodiment may be contained within or is otherwiseattached to the apparel/garment(s). As such, the apparel may includebatteries and/or a port for receiving electrical power, as well as auser interface as described above.

[0114] Additional advantages and modifications will readily appear tothose skilled in the art. The invention in its broader aspects istherefore not limited to the specific details, representative apparatusand method, and illustrative example shown and described. For instance,features of the present invention may have particular application intreating arthritis and diabetes, in addition or in the alternative tostimulating a muscle. Success in these areas may be attributable, inpart, to the manipulation of blood flow enabled by embodiments of theinvention. For instance, an apparatus consistent with the invention mayincrease blood flow according to the signal's travel through amusculature. Other uses of the present invention may extend to the fieldof chiropracty. A method consistent with the invention may provideparticular benefits if used to stimulate a musculature within arelatively short period of time following an injury. Accordingly,departures may be made from such details described herein withoutdeparting from the spirit or scope of applicant's general inventiveconcept.

What is claimed is:
 1. A method of stimulating a muscle, comprisingapplying a stimulating signal to a user wearing a garment that includesan electrode configured to apply the signal.
 2. The method of claim 1,wherein applying the signal further includes applying the signal to theuser in contact with a garment comprising a glove.
 3. The method ofclaim 1, wherein applying the signal further includes applying thesignal to the user in contact with a garment comprising a vest.
 4. Themethod of claim 1, wherein applying the signal further includes applyingthe signal to a user in contact with at least one garment selected froma list consisting of: a glove, a uniform, a shoe, a sock, a vest, asleeve, a shirt, a hat, a helmet, a brace, a suspender, eye wear, a pad,jewelry, a watch and pants.
 5. The method of claim 1, wherein applyingthe signal further includes applying the signal to the user while theuser moves while wearing the garment.
 6. The method of claim 1, whereinapplying the signal further includes applying a signal comprising aresonant sequence that includes at least three pulses, and wherein thepulses of the resonant sequence are spaced relative to one another suchthat each pulse subsequent to a first pulse in the sequence is effectiveto progressively stimulate and create tension in a musculature thatincludes the muscle inwardly from the electrodes and towards the centerof the musculature while maintaining the tension created in at least aportion of the musculature by each preceding pulse in the resonantsequence.
 7. An apparatus for stimulating a muscle, comprising: awearable item; a stimulator in communication with the wearable itemconfigured to produce a signal for transcutaneous delivery to themuscle,
 8. The apparatus of claim 7, wherein the signal is delivered asthe user moves the moveable instrument.
 9. The apparatus of claim 7,wherein the wearable item includes an electrode configured to deliverthe signal from the stimulator.
 10. The apparatus of claim 7, whereinthe wearable item comprises a glove.
 11. The apparatus of claim 7,wherein the wearable item is selected from a group consisting of: aglove, a uniform, a shoe, a sock, a vest, a sleeve, a shirt, a hat, ahelmet, a brace, a suspender, eye wear, a pad, jewelry, a watch andpants.
 12. The apparatus of claim 7, wherein the application of thesignal is affected by input from an input device selected from a groupthat consists of: a button, a switch, a motion sensor, a voice sensorand a dial.